Medicine for adults with attention-deficit hyperactivity disorder (ADHD) can help with symptoms. But if patients don't follow their doctors' orders, medicine might not be so helpful.
A recent study found that adults with ADHD who took their medicine as directed at least 95 percent of the time had the best symptom improvement. The people most likely to stray from doctor’s orders were women, people with a college degree and people who recently found out they had ADHD.
The study, led by J.J. Sandra Kooij, PhD, of the PsyQ Program and Expertise Center Adult ADHD at the Hague in The Netherlands, wanted to know what factors influenced whether or not adults with ADHD took their Ritalin (methylphenidate) as directed.
During the 13 week trial, participants were instructed to take two capsules per day. A total of 172 participants took methylphenidate in one of two doses. Another 97 participants took a sugar pill.
The researchers looked at the percentage of pills taken each day and over the entire 13 weeks.
Patients taking methylphenidate took their medicine properly about 93 percent of time. Patients who were taking a sugar pill took their medicine properly about 98 percent of the time.
About 50 percent of people taking methylphenidate took their medicine correctly every day throughout the study. For people taking sugar pill, about 60 percent took their pills correctly every day of the study.
The researchers found that women, people who had been more recently diagnosed with ADHD and people with more education were most likely to misuse or skip pills during the study.
People who had problems with alcohol and drug use were also less likely to follow their doctor's orders for ADHD medicine. The Drug Use Screening Inventory measures alcohol and drug use along with psychiatric symptoms related to drug abuse. The higher a person's score on the Drug Use Screening Inventory, the more likely they were to miss taking their ADHD medicine.
People who took their medicine correctly at least 95 percent of the time had more improvement in their ADHD symptoms by the end of the study period.
The authors concluded, “Clinicians and policymakers should therefore pay special attention to these individuals, as non-adherence is a significant predictor of reduced response to treatment.”
dailyRx News spoke with psychiatrist Glen Elliott, MD, PhD, about this study.
He said, “Information of this type is crucial for prescribing doctors, because failure to adhere to a treatment regimen is a common factor for poor response. It would be interesting to learn whether the factors identified here are common across other treatments for different disorders or unique to this ADHD population.”
This study was published January 24 in BMC Psychiatry. The study was funded by Janssen–Cilag EMEA. The authors reported affiliations with Janssen, Eli-Lilly, Novartis, Shire and other pharmaceutical companies.